Individual
DR. TERRY DEAN THOMPSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
D.C., C.C.S.P.
Contact information
Practice address
117 S MAIN ST, PALESTINE, IL 62451-1265
(618) 586-5454
(618) 586-9470
Mailing address
117 S MAIN ST, PALESTINE, IL 62451-1265
(618) 586-5454
(618) 586-9470
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
038-004727
IL
111NS0005X
Sports Physician Chiropractor
Primary
038.004727
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
038004727
—
IL
01
—
371140723
FEIN
IL
Enumeration date
03/14/2006
Last updated
01/10/2009
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